PATHOLOGY. 
courfe remedilefs ; and the third clafs will be treated of 
under apoplexy, with the exception of a brief notice in 
this place. 
In the refufcitation of perfons drowned or hanged, or 
rendered infenfible by mephitic vapours, the firft object 
will be to place the fyftem in that ftate of temperature 
molt favourable to the development of the nervous func¬ 
tion ; viz. that of warmth. The fame remark is applica¬ 
ble to cafes of fufpenfion of life from cold. It is to be 
ftridtly obferved, however, that the reftoration of heat to 
the body be not fuddenly effedled ; for, if Jlimulation be 
difproportionate to excitability, excitation will not be ma- 
nifelled, confequently the increafe of temperature fliould 
in all cafes be at firft very fmall, and gradually augmented. 
With refpedf to the quicknefs with which the increafe of 
heat is to go on, this muft vary according to circumftances. 
We may go on much quicker when fufpended anima¬ 
tion arifes from hanging, drowning, or breathing foul 
air, than when the body has been frozen. We alfo be¬ 
gin with a higher temperature at once ; for, in the latter 
cafe, the fridtion of the body with water, or even fnovv, 
muft be the prelude to higher degrees of temperature, 
while in the former we may at once put the patient into 
a warm bed, or immerfe him in warm grains or water, or 
whatever may be at hand. 
A flexible pipe being introduced through the pharynx 
into the ftomach, a little warm wine and water, with a 
very minute dofe of ammonia, may be injected ; fome 
advife alfo injeftion per ano. While this is doing, the 
lungs are to be inflated : this is belt done by cutting a 
hole in the front of the trachea, and introducing a tube 
affixed to Hunter’s bellow's ; or, if they are not at hand, 
a common bellows may fuffice; the lungs being alter¬ 
nately filled with air, and then exhaufted of it by pref- 
fure on the cheft. Oxygen may be ufefnlly employed 
when procurable, efpecially in cafes of A. mephytica. 
If a figh beat at the heart, if the flighted: change in the 
colour of the (kin, fliould indicate an effort on the part 
of the heart to refume its fundtions, a little blood fliould 
be drawn from the arm, and a (hock of eledlricity of the 
moft infignificant degree paffed through this organ. The 
force of the electricity may gradually be increased. 
The above rules embrace all that is requifite for the 
refufcitation of life. With refpedl to the time at which 
they are admiffible, no rule can be laid down. We may 
realonably hope for fuccefs when the patient has not 
l>een more than a quarter of an hour deprived of air. 
Seldom do they recover after twenty minutes. Yet fo 
many aftonifliing cafes of refufcitation, after the moft ex¬ 
traordinary laple of time, are oii record, (e. g. fixteen 
or eighteen hours, three days, fifteen days, fee Parr’s 
Medical Dictionary, p. 627.) that we fliould ufe fome 
meafures even in any cafe within the bounds of pro¬ 
bable reftoration. But, after twenty minutes’ hanging, 
or three or four hours of fubmerfion, w’e fliould be 
careful not to revive the hopes of the fufferer’s relatives 
merely to plunge them into deeper affliction, by com¬ 
mencing any plans of refufcitation. We cannot pals over, 
on this fubjeCt, a negleCt very common among practition¬ 
ers in general; viz. the defertion of perfons fuddenly falling 
(apparently) dead in a fit. It is ufual to open a vein or 
artery ; and, if no blood flow, the patient is given up for 
loft. This practice, defervedly reprobated by the higher 
orders of the profeflion, and by no means trufted to in 
our hofpitals, chiefly belongs to the general practitioner. 
It is acknowledged that thefe fudden vifitations are of¬ 
ten irremediably fatal ; but neverthelefs we are wrong 
in fuppofing them to be always fo. Often when the 
veins do not bleed, and the heart remains perfectly qui- 
efcent, both thefe phenomena will appear if ftimulating 
inflations be thrown into the ftomach and inteftines, and 
a (hock of eleCtricity paffed through the heart. On this 
account, thefe falutary meafures, as well as inflating the 
lungs, fliould never be negleCted. 
This grofs abandonment of our fellow-creatures has 
VOL.XIX. No. 1306. 
813 
been feelingly and forcibly dwelt upon by Mr. White in 
his work on the “ Diforder of Death.” This author in¬ 
culcates the adoption of refufcitative meafure in all cafes 
of fudden death. We fliould, for obvious reafons, not 
have recourfe to it, however, in any but doubtful cafes. 
Dr. Good gives us another variety of Carus, quite be¬ 
yond the reach of the art of medicine. 
A. eleflrica; from lightning, or fevere ftroke of 
eleCtricity: limbs flexible; countenance pale; blood 
uncoagulable. In this variety the fyftem feems to be 
totally exhaufted of its irritable and contraClile power. 
2. Carus ecftafis, ecftacy: total fufpenfion of mental 
power and voluntary motion ; pulfation and breathing 
continuing; mufcles rigid; body ereCt and inflexible. 
Said to be produced by profound contemplation or at¬ 
tention of mind, or overwhelming paffion ; in which cafe 
it is reverie with a fpaftic diathefis. Dr. Cullen regards 
it as a modification of apoplexy. 
3. Carus catalepfia, trance: total fufpenfion of men¬ 
tal power and voluntary motion ; pulfation and breath¬ 
ing continuing ; mufcles flexible ; body yielding to and 
retaining any given pofition. 
In this fpecies the countenance is faid to be florid, and 
the eyes open, and apparently fixed intently upon an 
objeCl, but without vifion. It is a difeafe of rare occur¬ 
rence ; and varies in its duration from a few hours, 01- 
even minutes, to two or three days. It returns fome- 
tirnes at ftated periods. Forty grains of tartar emetic 
have been given without effeCt. (Behrends, in Baldin- 
gen N. Magazin, Band ix. p. 199.) In the cafe of a 
lchool-boy, aged eleven years, the paroxyfms recurred 
ten times in twenty-four hours, and never exceeded three 
minutes in duration. If the attack commenced while 
walking, the fame pace was maintained, though without 
the diredfion of the mind. (Stearns, Americ. Med. and 
Phil. Regift. v. i. viii.) The nofologifts, however, men¬ 
tion a variety, in which the powers of deglutition and 
digeftion continue, the food being thruft into the mouth. 
It has been found to be produced by the fame caufes as 
the preceding fpecies ; and in thefe cafes is perhaps re¬ 
verie with a fpaftic diathefis. Cullen ranks this alfo as 
a modification of apoplexy ; but, like the preceding, it 
is dellitute of ftertorous deep. The exiftence of cata- 
lepfy may however be reafonably doubted. It has been 
o(ten feigned by impoftors. 
4. Carus lethargus, lethargy: mental and corporeal 
torpitude, with deep quiet deep. The term is applied 
by the Arabian phyficians, not only to the varieties enu¬ 
merated below, but to comatofe affedtions generally. 
«. L. abfolutus: without intervals of fenfation, wak¬ 
ing, or confcioufnefs. 
/ 3 . L. cataphora, fomnolency : with (hort remiflions or 
intervals of imperfedt waking, fenfation, and fpeech. 
7. L. vigil, apparent deep : perfedt lethargy of body, 
but imperfedt lethargy of mind; wandering ideas, and 
belief of wakefulnefs during deep. 
Each of thefe varieties is found asafymptomin fevers 
of various kinds; concuffion or other injuries of the 
brain ; and repelled gout, or other fuppofed humours or 
exanthems. 
5. Carus apoplexia, apoplexy : mental and corporeal 
torpitude, with ftertorous deep. Dr. Good notes two 
varieties. 
a.. A. fanguinea, fanguine apoplexy ; with a hard full 
pulfe and fluffed countenance. 
( 3 . A. ferofa, ferous apoplexy ; with a feeble pulfe and 
pale countenance. 
The varieties of Dr. Good we (hall not adopt. The 
recent light which the continental phyficians have 
thrown on the fubjedt of apoplexy by their diffedtions, 
and the experience of our own pradlical authors, unite 
in overturning the above diftindtion. A number of ar¬ 
rangements have been made from the few fadts known, 
which will as inevitably be difcarded. In the mean time 
we may remark, that the dividing a difeafe into many 
4 N varieties 
